[Pattern of diet and supplement consumption among multiple sclerotic patients pre and post diagnosis and their attitudes toward the effects of these parameters on disease progression]

Multiple Sclerosis [MS] is one of the central nervous system white matter disorders, with variable prevalence in various districts. Some researches proposed the probable effects of diet as a risk factor in the etiology and control of MS due to its variety of patterns in diverse cultures and regions. Determination of the MS patients' dietary habits, before and after diagnosis of the disease and their attitude toward the effect of dietary parameters on the disease progression. In this cross-sectional study, A total of 166 confirmed MS patients referred to Tabriz MS society during 2005 to 2006 were assessed by a pretested questionnaire composed of 3 sections of questions about demographic informations, dietary habits pre and post disease diagnosis, weight and appetite changes and also changes in dietary patterns after diagnosis. Data were analyzed by t-student test and qi2 in SPSS version 16. A total of 122 women and 44 men participated with the mean age of 31.97 +/- 9.21 years, and the mean age of diagnosis 28.33 +/- 8.84 years, in this study. As revealed, 79.8% of the patients didn't change their dietary patterns mainly because of their inattention to probable effect of nutrition on symptoms of disease in 80% of cases. There was a significant change in the type of using oil that reduced the disease severity among 50% of the patients. Also, there was a significant increase in the usage of dietary supplement and fish oil and a significant decrease in tendency toward egg, sugar, and pickles, following the disease. The patients suggested that fruits, milk, olive and its oil, vegetables, fish and nuts are sequentially alleviating the symptoms but pickles, hot [chilli] foods, confectionary products, fried foods, conserved food and red meat aggrevating the symptoms. From patients' viewpoints, dietary patterns and supplements are somehow effective on the symptoms of multiple sclerosis

[Hearing loss in multiple sclerosis patients]

Multiple sclerosis is one of demyelinating disorder of CNS that is an uncommon cause of the sensorineural hearing loss. This study was done to determine the hearing loss in multiple sclerosis patients. This case-control study was performed on 60 [44 women, 16 men] multiple sclerosis patients and 38 [27 women, 11 men] normal subjects by pure tone audiometery, otoacustic emissions and auditory brainstem responses in Gilan provine, Iran during 2010-11. Data was analyzed by using SPSS-17, Chi-Square and Fischer tests. 12.5% of case and 3.9% of the control ears had abnormal pure tone audiometery [P<0.05]. The frequencies of abnormal HF-pure tone audiometery and two modalities of otoacustic emission did not show any significant differences in two groups. Abnormal autidory brainstem response of ears were observed in 20% and 9.2% of cases and controls, respectively [P<0.05]. 20% of case and 9.2% of the control ears had abnormal auditory brainstem response [P<0.05]. The absolute latencies of waves I, II and V had not significant differences between two groups. Inter peak latencies of I-III and III-V waves were observed in 10% and 11.7% in cases ears and 1.3% and zero percent in controls, respecticely. 6.7% of cases and 2.6% of control ears had retrocochlear abnormality. Hearing loss detected by pure tone audiometery and auditory brainstem response is more common in multiple sclerosis compared to normal population

[Magnetic resonance imaging findings in sudden sensorineural hearing loss]

Sudden deafness [SD] is one of the major complaints of patients who referred to otolaryngology or neurology clinics. Most of the cases have idiopathic etiology; but some of them have other causes that must be diagnosed by appropriate diagnostic modalities such as Magnetic Resonance Imaging [MRI]. In this study, we showed the findings of MR Imaging in 32 patients with SD. Determination of MRI findings in sudden sensorineural hearing loss. We had performed gadolinium enhanced brain MRI, along Brainstem Auditory Evoked Potentials [BAEP] before treatment in 32 patients with SD referring to ENT Clinics of Kashani hospital in Isfahan and Amiralmomenin hospital in Rasht from August 2005 to September 2008 and were analyzed their results. Abnormal findings in MRI were reported in 6 cases [19.35%]. In 3 cases [2 females, 1 male] were found cerebello-pontine angle tumors in the same side of suggesting 8th cranial nerve schwannoma [acoustic neurinoma]. In one 45 years old male were found multiple hyperintense lesions in T2 and FLAIR that were hypo to isosignal in T1 and PD in pons, left cerebellar hemisphere and middle cerebellar peduncle that were more compatible with infectious, carcinomatous or lymphomatous processes and in 2 other cases, inflammatory process in mastoid regions, like mastoiditis were seen. Subcortical and periventricular lesions were found in one patient, compatible with migrainous changes and without any relating to SD. In one case MRI was normal but were found abnormal BAEP findings which indicatived an auditory neuropathy. In the investigation of the etiology of SD in patients, MRI is an invaluable instrument and can identify and clear up structural causes of sudden deafness

[ relationship between magnesium level and rankin disability score in ischemic stroke]

Cerebrovascular events are one of the most disabling disorders in human being and we must search for some factors that impress upon extent of tissue damage and neuronal injury that lead to the prognosis of these events and the patients abilities .One of these factors is magnesium. To investigate the relationship between magnesium level and rankin disability score at first 72hrs and 1week after ischemic stroke and change of this score in this period of time. In this cross-sectional study 67 patients suffering from ischemic stroke in the territory of right middle cerebral artery, less than 6 hours were involved. Their serum magnesium levels were measured in the first 6 hours after stroke and their RDS[0] and RDS[1w] were recorded. Data was analyzed by Nominal Regression Method and Repeated Measure ANOVA respectively by SPSS 17. Among 67 patients [61.20% was male and 38.8% was female], the mean age of them was 69.60 +/- 13.58 years old. There was reciprocal statistical correlation between serum magnesium level and RDS[0] and RDS[1w]. [P=0.000 and 0.002 respectively]. But there was not any significant statistical correlation between the serum magnesium level and changes of RDS in this period of time [P=0.513]. Measurement of serum magnesium level in the first hours after ischemic stroke can be a good predictor for patients abilities at the first 72 hours and 1 week after that event

[Assessment the effectiveness of omega 3 on migraine headache severity]

One of the mechanisms of migraine pain is neurogenic inflammation causing by induction of prostaglandins [PGs] and leukotrienes [LTs], it seems that polyunsaturated fatty acid omega 3 have anti-inflammatory and so analgesic effect by modifying their production. Determine the effect of omega-3 on the severity of migraine headache. In this randomized double blind clinical trial study, 198 patients who suffered from migraine and referred to the clinic of neurology in poursina hospital in Rasht, were selected from January to September 2009 according to IHS criteria. They were divided to two groups: 2 pearls of omega3 [2gr] were given to case group [97 patients] and 2 pearls of glycerol were given to control group for 3 months. Headache severity was graded according to MIDAS before and after treatment. The analysis was performed in each group by sign test. Comparing the changes of headache severity were assessed by repeated measure ANOVA variance were analyzed by SPSS 15. 97 patients in case group [27 male and 70 female] with mean age of 26.51 +/- 7.01 years and 99 patients in control group [28 male and 71 female] with mean age of 24.85 +/- 6.21 years participated in this study. This 2 groups were adjusted for age [P=0.081] and sex [P=1.000]. The reduction in headache severity in case group was 35.1% that was statistically significant [P=0.001] and in control group; 20.2% that wasn't statistically significant [P=0.154]. The changes in headache severity had statistically significant difference in these 2 groups [P=0.048]. Omega 3 is effective on reduction of migraine headache severity

Relationship between helicobacter pylori immunoglobulin G antibody and thrombotic ischemic stroke

Several studies have assessed association between Helicobacter pylori infection and thrombotic ischemic stroke. This study was designed to investigate the association between this organism and ischemic strokes. Antibody against H. pylori [Hp IgG] was measured in 81 patients with stroke and 43 subjects without stroke. Hp IgG titer more than 20 u/ml was defined as positive. Hp IgG seropositivity was found in 67.4% of control subjects and 70.4% of cases [P = 0.838]. The means of serum Hp IgG titers in control subjects and cases were 51.1859 u/ml and 50.1641 u/ml, respectively [P = 0.927]. The difference between these 2 groups was not significant statistically. There wasn't any significant difference in seropositivity of Hp IgG between case and control subjects in men and women. It seems that H. pylori IgG titer hasn't a predictive role for thrombotic ischemic stroke

[Evaluation of efficacy and complications of snuff box arterivenous fistulas in patients with chronic renal failure: ligation versus not ligation of distal vein]

Endogen arteriovenous fistulas [AVFs] are one of important hemodialysis access. According to current use of this technique, especially snuff box AVF, we compared the efficacy and complications of the two main techniques of snuff box AVFs, including with distal vein ligation and without ligation the vein. This double blind clinical trial was performed on 110 [11 to 83 years old] chronic renal failure [CRF] patients without evidence of proximal vein stenosis. Case and control group were matched regarding in age, sex, underlying disease and history of previous AVF. Vein distal to the site of AVF was ligated in case group and left open in control group. Patients were followed up in the days 1, 30, and 180 after the surgery to evaluate the efficacy and complications of two techniques. Short-term efficacy was 90% and 93.6% in case and control groups, respectively. Long-term efficacy was 90% in case group and 84.8% in control group [NS]. The most common complication in both groups was thrombosis followed by edema of the limb and venous hypertension. Venous hypertension was seen only in the control group [NS]. There are no statistical significant differences between two groups in efficacy and complications. Venous hypertension did not occur in any of the patients in case group. So, we recommend distal ligation of vein in snuff box AVFs

Evaluation of preoperative elevation of serum C-Reactive protein as an indicator for prognosis in Colorectal Cancer

The C-reactive protein [CRP] is a product synthesized in hepatocytes and has been reported to be up-regulated by such proinflammatory cytokines as interleukin-1 [IL-1], interleukin-6 [IL-6], and tumor necrosis factor [TNF]. The significance of a preoperative serum elevation in CRP as a predictive indicator for the malignant potential and prognosis in colorectal cancer has not been elucidated. Forty consecutive patients with colorectal cancer, whose local lesions were resected in our department, plus forty volunteer healthy persons, were selected. Any patient with inflammatory diseases such as infection or collagen disease was excluded from the current study. Then preoperative serum CRP level were measured, and also from the control group. The relationships between the serum elevation of CRP and both the clinicopathologic factors and prognosis of the patients was investigated. The rate of patients with elevated serum CRP level was significantly higher in colorectal cancer patients in comparison with the control group [55% versus 2.5%]. Furthermore the incidence of liver metastasis, peritoneal carcinomatosis, histopathologic lymph nodes metastasis, and tumor invasion in colorectal cancer patients with a preoperatively elevated serum CRP level were significantly more frequent than in those with a negative serum CRP level. The survival rates of colorectal cancer patients without a preoperative elevation of serum CRP proved to be significantly more favourable than what in colorectal cancer patients with such an elevation [94.4% versus 59.1%; P < 0.001]. A preoperative serum elevation of CRP was thus found to be an indicator of malignant potential of the tumor as well as a predictor for the prognosis of patients with colorectal cancer

[Comparative study of the plasma Homocysteine level in patients with mild Parkinson's disease and moderate to severe Parkinson's disease]

Patients with Parkinson's disease [PD] have higher concentration of plasma homocysteine [Hcy]. Elevation of total serum Hcy level has been known as a risk factor for neurodegenerative diseases. The aim of this study was comparison of serum Hcy level between PD patients with stage =< 2.5 and PD patients with stage > 2.5 [according to modified Yohen and Yahr method], and assessing the association between the duration of disease and Hcy levels. This case - control study was done on 50 patients with Parkinson's disease in the year 2005 in Al - Zahra Hospital of Isfahan. Patients divided into two groups: control group 1 included 23 patients with mild disease [stage=<2.5]; 27 patients with sever Parkinson's [stage>2.5] were put in the case group 1. Considering the duration of the disease, also, patients were divided into case 2 [more than 4 year duration with 24 patients] and control 2 [less than 4 year duration with 26 patients] groups. Hcy level was measured in all patients and compared in different groups. Individual and laboratory data were collected in questionnaire and analyzed using descriptive statistics and frequency distribution tables. The mean serum Hcy level in severe PD group was 24.96 micro mol/lit and in mild PD group was 25.07 micro mol/lit. There was no significant statistical difference between them. The mean serum level of Hcy, without any significant difference, in patients with duration of disease lower than 4 years was 23.51 micro mol/lit and in group with duration of more than that was 26.40 micro mol/lit. The present study showed that serum Hcy level doesn't have any relation with stage and duration of disease, and cannot be used as a predictive value for the progression of PD

[Chlamydia pneumoniae infection and thrombotic ischemic stroke]

Several studies have assessed the association between Chlamydia pneumoniae infection and thrombotic ischemic strokes. This study was designed to investigate the association between this organism and ischemic strokes in Iranian patients. Antibodies to Chlamydia pneumoniae[CP IgA and IgG] were measured in 81 patients with stroke and 43 controls. CP IgG and CP IgA titers more than 1.1 Immune Status Response [ISR] were considered as positive. We found that 9.3% of controls and 13.6% of cases were CP IgA seropositive. Although the difference between these two groups was prominent but it was not statistically significant [p=0.25]. The mean CP IgA titer was significantly higher in the case than in the control group [0.6 +/- 0.3 vs. 0.47 +/- 0.3 ISR, respectively, p=0.03]. This difference was not significant for CP IgG titer. The higher titer of CP IgA in patients with ischemic stroke than in controls might suggest the co-existence of this infection with ischemic stroke. Assessment of this association needs longitudinal studies

Human dirofilariasis due to dirofilaria repens in Ahvaz-Iran: a report of three cases

Zoonotic filariasis due to Dirofilaria repens is prevalent in several regions of the world and because of recent rise in the number of human infections in countries of Europe, Africa and Asia, it is considered an emerging zoonoses in these continents. In 2002 three cases of dirofilariasis were diagnosed. The first case was a 34 year old man from Ahvaz referred to dermatologist with a nodule on the right cheek. During the excisional biopsy an adult dirofilaria measured 120 mm in length with white color was removed. The second case was a 37 year old man from a village around Ahvaz city who noticed a single moveable nodule with itching, irritation and swelling, 1.5 cm in diameter on his chest. The patient pressed the nodule and a white worm with 130 mm in length was revealed. The third case was a 35 year old man from Ahvaz presented at Imam Khomeini hospital because of eye irritation with symptoms and signs of itching, swelling and redness of the right eye. Examination noticed a living worm with the length of 110 mm which removed from the subconjunctival space. The worms were examined in parasitology department and based on morphological characters and microscopical identified as Dirofilaria repens. This is the second report of subcutaneous and the first report of subconjunctival dirofilariasis from Iran